Susan B Stiller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

983018 Issued in CO

Practice address

710 Hunter Dr
Pueblo, CO 81001-1812

Phone

(719) 595-0020

Fax

(719) 542-1634

NPI assigned

Jun 22, 2006

Last updated

Jan 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alpine Counseling LLC

  • Clinical Social Worker
  • Pueblo, CO
  • NPI 1184650236
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1730125246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 HUNTER DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011812",
            "telephone_number": "719-595-0020",
            "fax_number": "719-542-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 HUNTER DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011812",
            "telephone_number": "719-595-0020",
            "fax_number": "719-542-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLER",
        "first_name": "SUSAN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "983018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #302191",
            "identifier": "302191",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034147",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rick S. Stewart, PHD
• Shirley Jo Stice, COTA
• Meghan S Stich, LCSW
• Derek Wade Stickler, D.C.
• Krysta Stickler, D.C.
• Lisa Stiner, RDH
• Richard M Stiphout, MD
• James R Stjernholm, M.D.
• Thomas Christian Stjernholm, M.D.
• Camila Stocking

• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.